One of the biggest questions about the Patient-Driven Groupings Model (PDGM) on everyone’s mind is “what about therapy?” While the new model eliminates the therapy thresholds for payment, PDGM case mix includes mechanisms to include all disciplines.
In our complimentary PDGM Readiness webinar, Gina Mazza and Kerry Termine explain how therapy will be reimbursed in the PDGM case mix structure — and provide best practices for providing high quality patient-centered therapy services under this payment model.
Continue reading “PDGM Readiness Webinar Recording: What About Therapy?”
Yesterday, our parent company, WellSky, made the exciting announcement that Tim Ashe has been named WellSky’s Chief Clinical Officer (CCO). In this role, Tim will ensure that clinical imperatives, including the insights of frontline practitioners, are incorporated into the solutions developed for all WellSky customers as we partner with providers to advance patient care.
Tim will also continue to serve as Fazzi’s President, leading our 40-year mission of making a real difference in health care by strengthening the quality, value, and impact of health care at home; a charge shared and fueled by our parent, WellSky. Together, we are committed to delivering solutions that not only meet regulatory requirements, but also deliver clinical outcomes that improve the patient experience, better the overall health of populations and reduce costs.
Please join the Fazzi team in congratulating Tim!
Everyone knows that the Patient-Driven Groupings Model (PDGM) is the most sweeping change for Home Health since the Prospective Payment System (PPS), and industry veterans certainly remember that period of uncertainty and disruption.
With PDGM, yet again, every Home Health agency will need to adjust. And while you’ll need to analyze the impact on every core function, “step one” is to realize that what’s most important is leadership and the ability to manage change. Gina Mazza’s white paper, “Step One to PDGM: Leadership and Change Management” offers a “PDGM leadership checklist” to help get you started.
Continue reading “PDGM Readiness White Paper: It Begins with Leadership”
CMS has posted the quarterly Hospice Compare refresh of quality data on December 4, 2018. All quality measures showed improvement since the last quarterly posting! Pain assessment showed the most improvement, from 83.4% to 85.5%, followed by pain screening.
Updates to the family caregivers’ survey results showed seven measures remained the same.
CMS has added a new “Composite Process Measure” to Hospice Compare. As of this release, the national average is 83.6%.
Quality measure results are from data collected 1st quarter 2017 through 4th quarter 2017, and Hospice CAHPS® survey results reported 1st quarter 2016 through 4th quarter 2017.
View State Level Hospice Compare Charts
CMS created the service intensity add-on (SIA) in recognition of patients and families needing more intensive care and services at the very end of life. The SIA also recognizes the higher costs of those services by offering hospice providers reimbursement for them. Specifically, the SIA payment covers direct care provided by a registered nurse or social worker that occurs during the last seven days of life, up to four hours per day, in addition to the routine home care per diem reimbursement.
However, two years after the 2016 Hospice Payment Rule instituted the SIA, it is clear that many hospice organizations have not realized the opportunity for optimizing the reimbursement model, enhancing care during the last seven days of life and capturing the SIA payment.
Fazzi’s complimentary white paper written by Catherine Dehlin, Fazzi’s Director of Hospice Services entitled, “Does Your Hospice Team Understand Service Intensity Add-On?”, provides a more complete understanding of the benefit and best practice strategies to help ensure patients and families receive high quality end of life care. This paper is full of specific and actionable recommendations in these areas:
- Direct care
- Scheduling and staffing
- Escalation of services
- Care planning
- Interdisciplinary team communication
Following these recommendations will benefit patients and their families as well as help agency leaders access this important resource.
Continue reading “Understanding the Hospice SIA and Best Practices for Quality End of Life Care”
New Reasons to Outsource or to Examine Your Coding Vendor
The trend of outsourcing the coding function has been gaining momentum among home health and hospice agencies for a number of years. And now, with OASIS-D, the Patient-Driven Groupings Model (PDGM) and the changing regulatory landscape for hospice, the list of reasons to outsource – or to examine your coding vendor – is getting longer.
Our white paper entitled, “Is Coding Holding Your Agency Back?” provides important insights on this industry trend including a list of questions to ask your prospective or current coding vendor. Authors Kelly Murphy-Miller and Kerry Termine have packed a lot of information into a very readable five pages
Continue reading “Is Coding Holding Your Agency Back?”
Last month we encouraged you to access the information that CMS has provided to learn the potential impact of the Patient-Driven Groupings Model (PDGM) on your agency.
Today, we’re pleased to introduce our simplified “look-up” of CMS’ Agency-Level Impacts, Estimated for CY 2019 information. You can search for agencies by CCN or by State and City. As a reminder, CMS created these estimates using 2019 payment rates when they were expecting the original “HHGM” model to go into effect in 2019 (using 2017 data). So, while not an actual projection for 2020, it is still a good way to get a rough estimate of what the impact could be.
We will continue to keep you up to date about this important change for our industry.
Access the PDGM Potential Impact Look Up Tool Here
On October 24, 2018, the President signed into law H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act. The Act includes a section which amends the Controlled Substances Act and allows a hospice employee to handle lawfully dispensed controlled substances of deceased hospice patients to assist with disposal of the controlled substances, so long as the disposal occurs onsite in accordance with applicable law. Prior to this amendment to the Controlled Substance Act, hospice personnel were only allowed to instruct family members in proper disposal of controlled substances and were prohibited from handling the substances and/or assisting in the disposal. The law specifies that the disposal occurs onsite, meaning at the place of death, and that it is in accordance with any state or local laws.
Hospice agencies may now revise their policies, procedures, and practices to reflect this change. Policies such as Disposal of Controlled Substances, Procedures at Time of Death, Documentation Requirements at Time of Death, and electronic medical record revisions to include details of items disposed are some examples to consider. Agencies should keep in mind that this law is specific for disposal of controlled substances at time of death and does not include disposal of discontinued controlled substances on live patients. Educating clinicians and implementing the revised practice changes as soon as possible will help decrease the opioid diversion and misuse across America.
The summary of H.R. 6, sponsored by Rep. Greg Walden of Oregon, can be found at https://www.congress.gov/bill/115th-congress/house-bill/6. For details related to the hospice disposal, refer to Sec. 7062, Safe Disposal of Unused Medication Act.
The Home Health Compare results were updated on October 24, 2018.
For the Quality of Patient Care measures, 13 measures improved and 1 worsened. As with last quarter, improvement in bed transfer saw the most improvement of 1.4%. Improvement in management of oral medications improved by 1.2%. Depression assessment conducted worsened by 0.1%. (Data Collection January 1, 2017 – December 31, 2017).
Acute care hospitalizations remained at 15.8%, while Urgent, unplanned care in the emergency room worsened, increasing from 12.9% to 13.0%. (Data Collection January 1, 2017 – December 31, 2017).
The national average for the Quality of Patient Care Star Rating remained at 3.5 stars.
HHCAHPS measures also updated and the national averages remain the same. The data collection period for these measures and the Star Ratings is April 1, 2017 – March 31, 2018.
To see where the 5 star agencies are located, visit our Home Health Compare page and use the drop down for Star Ratings at the agency level. You can also compare measures by state, by year, by release date, and the top 10 or top 20 percent.
Understanding the Rule and the Reasons Behind it
Presenter Catherine Dehlin explains the key components of the rule along with the data and reasons behind CMS’ thinking. Get the details and data on:
- Hospice Wage Index Updates
- Payment Rates
- Cap Amounts
- Physician Assistants
- Hospice Quality Reporting Program
- Non-Hospice Covered Services – Part D Meds
- Portfolio Findings
Hospice providers are facing significant regulatory changes. Leaders need to understand the changes and the reasons behind them in order to successfully steer their organizations.
Continue reading “Complimentary Webinar: FY2019 Hospice Final Rule”